凝血功能指标及抗磷脂抗体检测在SLE患者合并血栓形成中的研究

Study on the Detection of Coagulation Function Indexes and Antiphospholipid Antibodies in SLE Patients with Thrombosis

目的:探讨抗磷脂抗体(antiphospholipid antibodies,APLs)、凝血功能指标对系统性红斑狼疮(SLE)患者血栓形成的预测价值。方法:选取2021年4月-2022年8月牡丹江医学院附属红旗医院风湿免疫科85例SLE患者,按照是否合并血栓形成将其分为血栓组(n=33)与非血栓组(n=52)。比较两组基本临床资料、APLs、凝血功能指标,根据受试者工作特征(ROC)曲线评估不同指标对于SLE患者合并血栓形成的预测价值,并分析SLE患者合并血栓形成的影响因素。结果:两组年龄、性别、有无高血压、有无狼疮性肾炎、TAT、FIB、APTT、IgA-ACL、IgM-ACL比较,差异均无统计学意义(P>0.05)。血栓组TM、D-D、PT、LA、IgG-ACL、抗β_(2)GPⅠ均高于非血栓组,差异均有统计学意义(P<0.05)。经ROC曲线分析显示,TM、D-D、PT、LA、IgG-ACL、抗β_(2)GPⅠ、各指标联合检测曲线下面积分别为0.764、0.740、0.646、0.708、0.686、0.675、0.848。logistic回归分析显示,D-D(OR=8.350)、LA(OR=124.238)是SLE患者合并血栓形成的独立危险因素(P<0.05)。结论:SLE合并血栓形成患者的TM、D-D、PT、LA、IgG-ACL、抗β_(2)GPⅠ水平呈现高表达,其中D-D、LA是SLE患者合并血栓形成的独立危险因素,在SLE血栓风险评估及血栓早期诊断中价值较高。

Objective:To investigate the predictive value of antiphospholipid antibodies(APLs)and coagulation function indexes of thrombosis in patients with systemic lupus erythematosus(SLE).Method:A total of 85 SLE patients in the Rheumatology and Immunology Department of Hongqi Hospital Affiliated to Mudanjiang Medical University from April 2021 to August 2022 were selected.They were divided into thrombus group(n=33)and non-thrombus group(n=52)according to whether there was thrombosis.The basic clinical data,APLs and coagulation function indexes between the two groups were compared.The predictive value of different indicators for SLE patients complicated with thrombosis was evaluated according to the participant operating characteristic(ROC)curve,and the influencing factors of SLE patients complicated with thrombosis were analyzed.Result:There were no significant differences in age,sex,hypertension,lupus nephritis,TAT,FIB,APTT,IgA-ACL and IgM-ACL between the two groups(P>0.05).TM,D-D,PT,LA,IgG-ACL and anti-β_(2)GPⅠin thrombus group were higher than those in non-thrombus group,with statistical significance(P<0.05).The ROC curve analysis showed that the areas under the curve of TM,D-D,PT,LA,IgG-ACL,anti-β_(2)GPⅠand combined detection of all indicators were 0.764,0.740,0.646,0.708,0.686,0.675 and 0.848,respectively.logistic regression analysis showed that D-D(OR=8.350)and LA(OR=124.238)were independent risk factors for thrombosis in SLE patients(P<0.05).Conclusion:The levels of TM,D-D,PT,LA,IgG-ACL and anti-β_(2)GPⅠare highly expressed in SLE patients complicated with thrombosis,among which D-D and LA are independent risk factors for SLE patients complicated with thrombosis,and they are of high value in SLE thrombosis risk assessment and early diagnosis.